Gujarat Pollution Control Board

Gujarat Pollution Control Board

SAMPLE FORMAT FOR THIRDY PARTY CERTIFICATION (SCHEDULE-1 OR SCHEDULE-2 AUDITOR) OF COMPLIANCE OF THE ORANGE CATEGORY INDUSTRY FOR EXEMPTION FROM ROUTINE INSPECTION (to be submitted before 31st March of every year to avail exemption for that calendar year)

To,

The Member Secretary,

Gujarat Pollution Control Board,

Gandhinagar

Sub: Third Party Certification for Compliance to avail exemption from routine inspection by GPCB.

Ref: Consolidated Consent and Authorization (CCA) issued by the Board vide No. ___ dated ______valid up to ______.

Sir,

We, Name of Auditor, a recognized Schedule – I/II Environment Auditor for Third Party Certificationto avail the scheme of exemption from routine inspection of orange category industries by GPCB, hereby undertake that the Environmental Management System provided by M/s. Name of Unit; for the products and capacity as stated in the annexure is adequate and efficient to achieve the standards (Water, Air, Solid Waste) as, specified by GPCB, Gandhinagar and the industrial unit is complying to the above referred CCA conditions.

Details of Industry:

Name of the Industry& PCB ID
Address
Contact Details
E-mail:
Contact No.:
Size& Category of Industry
Large Scale
Medium Scale
Small Scale
  1. M/s. Name of Unit has a valid CCA from GPCB vide above referred letter.
  2. The products which unit manufacturers do not violate the provision of EIA Notification of 2006.
  3. The production or manufacturing is as per the consented limits of the CCA. Details of Production Qty are as under.

Sr. No. / Product / Total Production
(MT/Year)
1
2
3
Total
By Products
1
2
  1. There is no change in type, quality and quantity of raw materials & products as has been mentioned in our above mentioned consent (CCA) Order and manufacturing process except for implementation of CP/CT leading to pollution reduction if required.Details are as under.

Sr. No. / RAW MATERIALS / Total Consumption/Year
Product Name
1
2
3
Product Name
1
2
3
Product Name
1
2
3
  1. Unit is complying with the conditions laid down in CCA issued to unit and that the emissions from the air and waste water discharges in last calendar year from the unit are within the norms prescribed in the CCA. Details are as under.

Waste Water Details:

Sr. No. / Purpose / Waste Water Consumption: Total KL/day / Waste Water Generation: Total KL/day
1 / Domestic
2 / Industrial
A / Process
B / Boiler
C / Cooling make up
D / Washing
TOTAL

Stacks Details:

Flue Gas Stack:

Sr. No. / Stack
Attached to / Stack
Ht * Dia(m) / Fuel Type / Fuel Quantity in MT/Year / APCM
1.
2.

Process stacks:

Sr. No. / Stack Attached to / Stack
Ht * Dia(m) / APCM / Pollutants
1.
2.

Hazardous waste details:

Sr. No. / Hazardous waste / Category / Quantity per Year in MT / Method of Disposal
  1. Unit has no dues of the GPCB in terms of Water Cess, analytical lab charges or any other dues.
  2. Unit has to comply with any further condition which may be stipulated by GPCB in future for the purpose of environment management and/ or pollution control as may be necessary.
  3. There is no case against the unit for violation of provision of any environmental acts is pending in the court of law.

The above information is true to the best of my knowledge and we understand that submission of false information or any change in the above information will lead to automatic cancellation of the benefit of the scheme to the said industrial unit and cancellation of recognition as an Environment Auditor to GPCB.

Thanking You,

Authorized Signatory

Name and Designation

With phone and email address &seal of the Auditor

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